Eponyms in Oncology: Zollinger-Ellison Syndrome

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This weekly series highlights eponyms in oncology. This week, we explore the history and namesakes of Zollinger-Ellison syndrome.

Zollinger-Ellison syndrome is a condition in which neuroendocrine gastrinomas form in the pancreas or duodenum.1,2 

About 60% of gastrinomas are malignant. The gastrinomas secrete gastrin, which causes the stomach to produce too much acid, and this leads to peptic ulcers in the stomach and duodenum.


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Patients with Zollinger-Ellison syndrome may present with prolonged diarrhea, nausea, vomiting, bloating, and abdominal pain or discomfort. They may also present with ulcer perforation and bleeding.  

History of the Name

Robert M. Zollinger, MD, and Edwin H. Ellison, MD, are the namesakes of Zollinger-Ellison syndrome.

Dr Zollinger was born in Millersport, Ohio, in 1903.1 He earned his medical degree from Ohio State University (OSU) in 1927.3 He joined the army in 1941 and became assistant chief of the surgical service for his unit. In 1947, he became chair of OSU’s department of surgery.

Dr Ellison was born in Dayton, Ohio, in 1918.1 He completed his medical education at OSU and joined the university’s department of surgery in 1944.4 Dr Ellison received his surgical training from Dr Zollinger. 

In 1955, Drs Zollinger and Ellison identified the condition that would later bear their names.5 The pair reported cases of 2 young women who presented with perforated jejunal ulcers. Both patients had severe gastric hypersecretion.

Dr Zollinger performed an operation on one of the patients that proved unsuccessful but provided insight into the condition. He had submitted a video of the operation to the American College of Surgery’s Motion Picture Committee. This prompted the committee’s chair, Dr Hilger P. Jenkins, to suggest exploring the pancreas for tumors. 

Both patients were found to have at least 1 non-insulin secreting islet cell tumor. Drs Zollinger and Ellison theorized that a hormone secreted from these tumors was causing the gastric acid output that resulted in the peptic ulcer syndromes. 

In 1956, the term “Zollinger-Ellison Syndrome” was coined by Dr Ben Eiseman when he reported a patient with the same condition Drs Zollinger and Ellison had described. 

Although others had reported patients with similar conditions in the past, Drs Zollinger and Ellison were the first to propose that a hormone other than insulin was being secreted by the pancreas and caused the syndrome.

In 1960, Dr Roderic Gregory and Dr Hilda Tracy extracted a gastrin-like substance from the pancreas of a patient with Zollinger-Ellison syndrome, establishing gastrin as the hormone that causes the syndrome.

Dr Zollinger was chair of OSU’s department of surgery from 1947 to 1974, and he served as editor-in-chief of the American Journal of Surgery from 1958 to 1986.1 He died from pancreatic cancer in 1992.

Dr Ellison remained on the OSU faculty until 1957.4 After that, he became chairman of the division of surgery at the Marquette School of Medicine (now the Medical College of Wisconsin). He died by suicide in 1970.6 

Editor’s Note: If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-8255.

References

1. Kumar P, Brazel D, Benjamin DJ, Brem E. Eponyms in medical oncology. Cancer Treat Res Commun. 2022;31:100516. doi:10.1016/j.ctarc.2022.100516

2. Kanne JP, Rohrmann CA, Jr, Lichtenstein JE. Eponyms in radiology of the digestive tract: Historical perspectives and imaging appearances. RadioGraphics. 2006;26:129-142. https://doi.org/10.1148/rg.261055084

3. Robert M. Zollinger, MD. Historical Reflections: The Medical Heritage Center Blog. The Ohio State University. Published April 11, 2011. Accessed May 9, 2022. https://library.osu.edu/site/mhcb/2011/04/11/robert-m-zollinger-md/

4. The Edwin H. Ellison Memorial Lectureship. Medical College of Wisconsin. Accessed May 9, 2022. https://www.mcw.edu/-/media/MCW/Departments/Surgery/Lectureships-Named/The-Edwin-H-Ellison-Memorial-Lectureship.pdf

5. Kaplan EL, Tanaka R, Ito K, Younes N, Frieson SR. The discovery of the Zollinger-Ellison syndrome. J Hep Bil Pancr Surg. 1994;1:509-516. https://doi.org/10.1007/BF01211912

6. Navarro S. Eponyms in pancreatology: The people behind the names. Gastroenterol Hepatol. 2017;40(4):317-326. doi:10.1016/j.gastrohep.2016.03.008



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